Screening and Treatment of Tobacco Use Disorder in Mental Health Clinics in New York State: Current Status and Potential
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ORIGINAL PAPER
Screening and Treatment of Tobacco Use Disorder in Mental Health Clinics in New York State: Current Status and Potential Next Steps Adria Zern1 · Michael Seserman2 · Heather Dacus3 · Barbara Wallace3 · Susan Friedlander4 · Marc W. Manseau5 · Maxine M. Smalling4 · Thomas E. Smith1,4,6 · Jill M. Williams7 · Michael T. Compton1,6 Received: 7 April 2020 / Accepted: 5 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The prevalence of smoking is higher among individuals with serious mental illnesses than the general population. Evidencebased practices exist for tobacco cessation, but little is known about mental health clinics’ tobacco cessation treatment practices/protocols. Mental health clinics in New York State were surveyed about their tobacco use treatment protocols and outdoor-smoking policies. One-third of clinics were not providing individual counseling for tobacco use disorder, 39% were not prescribing nicotine replacement therapy, and nearly half reported not prescribing bupropion or varenicline. Even smaller proportions reported implementing other clinical practice guidelines, with only 25.2% providing staff training and 20.3% having a dedicated staff member for coordinating tobacco use disorder treatment. Regarding outdoor smoke-free policies, 38% of clinics reported not allowing any tobacco use anywhere on grounds. Despite some successes, many clinics do not provide evidence-based tobacco use treatments, meaning important opportunities exist for mental health clinics and oversight agencies to standardize practices. Keywords Serious mental illnesses · Smoking · Tobacco · Clinics
Introduction Individuals with serious mental illnesses (SMI) are more likely to be heavy smokers, have greater nicotine dependence, experience stronger withdrawal symptoms when attempting to quit, and exhibit lower quit rates compared
to the general population (Khanna et al. 2016; Prochaska et al. 2017). There is nearly a five-fold greater prevalence of smoking among individuals with schizophrenia, bipolar disorder, posttraumatic stress disorder, and substance use disorders (SUDs) than in the general population (Prochaska et al. 2017). Additionally, in nationally representative
* Michael T. Compton [email protected]
Thomas E. Smith [email protected]
Adria Zern [email protected]
Jill M. Williams [email protected]
Michael Seserman [email protected]
1
Heather Dacus [email protected]
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
2
American Cancer Society, Latham, NY, USA
Barbara Wallace [email protected]
3
New York State Department of Health, Albany, NY, USA
4
New York State Office of Mental Health, Albany, NY, USA
5
New York University, New York, NY, USA
6
New York State Psychiatric Institute, New York, NY, USA
7
Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunsw
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